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Exploring the link between GLP-1 receptor agonists and dementia: A comprehensive review
Mallika Chuansangeam1, Pawit Phadungsaksawasdi2, Hyo Jin Park3
1Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
Journal of Alzheimer'S Disease Reports
|May 15, 2025
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) show cognitive benefits for type 2 diabetes patients, even without metabolic changes. These agents may also preserve brain function in early dementia and Alzheimer's disease.
Area of Science:
- Neuroscience
- Endocrinology
- Metabolic Disorders
Background:
- Type 2 diabetes mellitus (T2DM) and insulin resistance are linked to cognitive decline and dementia, including Alzheimer's disease (AD).
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially for glycemic control, are showing potential neuroprotective effects.
Purpose of the Study:
- To review the evidence on GLP-1RA effects in T2DM patients with and without cognitive impairment, and in AD patients.
- To assess GLP-1RAs' impact on cognitive function, brain metabolism, and AD biomarkers.
Main Methods:
- A comprehensive literature search was performed.
- Ten studies were included: 6 randomized controlled trials, 1 prospective open-label study, and 3 observational studies.
Main Results:
- GLP-1RAs consistently provided cognitive benefits in T2DM patients, irrespective of metabolic improvements.
- In early dementia/AD, GLP-1RA treatment maintained brain metabolism and connectivity but did not significantly alter amyloid or tau biomarkers.
- Cognitive gains were more pronounced in individuals with higher BMI or obesity. Neural functional changes were observed, but not consistent modifications in AD biomarkers.
Conclusions:
- GLP-1RAs may enhance cognitive outcomes and brain function, particularly in early neurodegeneration and high-risk T2DM populations.
- Further clinical trials are necessary to confirm the impact of GLP-1RAs on dementia progression and pathology.
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